Australian Psychiatrists urge authorities to lift nicotine ban

Psychiatrists down under are speaking up against the local ban on nicotine-containing vaping products, and pointing out how switching to the proven safer alternatives could improve their patients’ quality of life.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP), said that mentally ill individuals have a higher tendency to smoke than healthier members of the public. Hence, they would benefit greatly from having access to the safer alternatives, that would at least decrease the likelihood of them experiencing the preventable ailments associated with smoking.

“E-cigarettes … provide a safer way to deliver nicotine to those who are unable to stop smoking, thereby minimising the harms associated with smoking tobacco and reducing some of the health disparities,” said the organization. “The RANZCP therefore supports a cautious approach that takes into account …the significant health benefits which these products present.”

“E-cigarettes … provide a safer way to deliver nicotine to those who are unable to stop smoking, thereby minimising the harms associated with smoking tobacco and reducing some of the health disparities. The RANZCP therefore supports a cautious approach that takes into account …the significant health benefits which these products present.” The Royal Australian and New Zealand College of Psychiatrists (RANZCP)

RANZCP board member, Professor David Castle, pointed out that the current regulations are working against people with mental problems. Talking figures, 70% of schizophrenia sufferers and 61% of people with bipolar disorder are smokers, in comparison to the 16% of mentally healthy individuals.

“It’s not like we’ve banned cigarettes, they’re available and legal, but there are restrictions, and we would go with similar restrictions for e-cigarettes,” he said. “The literature shows the risk of cancer is much reduced with e-cigarettes because what actually raises that risk are the aromatic hydrocarbons and other things within the paper and the tobacco. We’re talking about nicotine as a chemical substance released in a vapour form, so it’s a very different scenario.”

Regulatory situation in Australia

70% of schizophrenia sufferers and 61% of people with bipolar disorder are smokers, in comparison to the 16% of mentally healthy individuals.

Earlier this month, other Australian doctors also launched a plea addressed to the federal parliamentary committee pointing out that smokers should have access to vaping products that would give them the nicotine hit that they are addicted to, without the other harmful components contained in cigarette smoke.

In Australia e-cigarette devices are legal, but using nicotine-containing refills are not. In August 2016, many public health activists, amongst which the New Nicotine Alliance (NNA), had submitted proposals to local regulator Therapeutic Goods Administration (TGA), to remove nicotine concentrations of below 3.6% from the Poisons Standard. Their argument was that nicotine containing e-cigarettes hold a lot of potential if used for smoking cessation, and are at best excellent harm reduction tools.

However, in February 2017, the TGA rejected the application and upheld the nicotine ban. “The TGA is essentially saying to the hundreds of thousands of Australians who have already quit smoking by using e-cigarettes: You quit the wrong way. We are not going to let you do this. But you can go and buy a pack of smokes, no problem.” said Dr. Attila Danko from NNA AU, at the time.

RANZCP adopts a different stance from medical community in Australia

Renowned doctor, and tobacco treatment specialist Colin Mendelsohn, who is also an Associate Professor in the School of Public Health and Community Medicine at the University of NSW labelled the RANZCP’s position as being in “sharp contrast” to the Australian Medical Association’s (AMA) “prohibitionist view”.

He applauded the RANZCP for looking at the evidence and taking a leading position in breaking away from the Association. “The AMA’s position paper was a disgrace, I was embarrassed; they ignored all the international evidence, that New Zealand and Canada have looked at the evidence and decided to make e-cigarettes legal,” said Mendelsohn.

“It’s not like we’ve banned cigarettes, they’re available and legal, but there are restrictions, and we would go with similar restrictions for e-cigarettes. The literature shows the risk of cancer is much reduced with e-cigarettes because what actually raises that risk are the aromatic hydrocarbons and other things within the paper and the tobacco. We’re talking about nicotine as a chemical substance released in a vapour form, so it’s a very different scenario.” Professor David Castle Board Member, RANZCP

However, the president of Australian Medical Association (AMA), Dr. Michael Gannon, is denying that that RANZCP’s stance contrasts in any way with that of the AMA. “The AMA takes a more population health view of the issues and worries significantly about the normalisation of vaping and the evidence that suggests it represents a gateway drug to heavier use of tobacco,” he said. “RANZCP, representing doctors in two countries, has carefully looked at the evidence and come up with a different view, which recognises the needs of their patients.”

AMA still referring to the proven unsound ‘Gateway Theory’

“The AMA’s position paper was a disgrace, I was embarrassed; they ignored all the international evidence, that New Zealand and Canada have looked at the evidence and decided to make e-cigarettes legal.” Dr. Colin Mendelsohn, Associate Professor in the School of Public Health and Community Medicine at the University of NSW

The Australian doctors who addressed the federal parliamentary committee earlier in July, pointed out how smoking rates have drastically decreased in countries where vaping was either endorsed, such as in the UK, or where nicotine-containing e-liquids are at least available, such as in the US. Additionally, they pointed out that that the theories that vaping either normalises (or acts as a gateway to) smoking, which the AMA referred to above, have been proven unsound.